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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Creative Concept Testing on Antimicrobial Resistance
Agency IC Tracking Number:
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
0920-1154
Focus Group Screener for Consumers, Including Parents
Attachment 1_WS-CDC ARX_Concept Testing Screener_Consumer FGs_5.10.24_V1.docx
Yes
No
Fillable Fileable
Form and Instruction
0920-1154
Interview Screener for Healthcare Providers
Attachment 2_WS-CDC ARX_Concept Testing Screener_HCP IDIs_5.10.24_V1.docx
Yes
No
Fillable Fileable
Form and Instruction
0920-1154
Focus Group Guide for Consumers about Antimicrobial Resistance Concept Testing
Attachment 5_WS-CDC ARX_Concept Testing Guide_Consumer FGs_5.31.24_FINAL.docx
No
Paper Only
Form and Instruction
0920-1154
Interview Guide for Healthcare Professionals about Antimicrobial Resistance Concept Testing
Attachment 6_WS-CDC ARX_Concept Testing Guide_HCP IDIs_5.31.24_FINAL.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
616
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
616
0
616
0
0
0
Annual IC Time Burden (Hours)
127
0
127
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
SSA
Attachment 6_WS-CDC ARX_Concept Testing Guide_HCP IDIs_5.31.24_FINAL.docx
06/14/2024
SSB
WS-CDC ARX_Creative Testing OMB Supporting Statement B_FINAL.docx
06/14/2024
Request for Approval under the “Generic Clearance for the Collection (OMB Control Number: 0920-1154)
WS-CDC ARX_Creative Testing Gen IC Request Form_FINAL.docx
06/14/2024
Focus Group Consent Form for ARX Creative Concept Testing
Attachment 3_WS-CDC ARX_Concept Testing Consent Form_Consumer FGs_5.10.24_V1.docx
06/14/2024
Interview Consent Form for ARX Creative Concept Testing
Attachment 4_WS-CDC ARX_Concept Testing Consent Form_HCP IDIs_5.10.24_V1.docx
06/14/2024
Antimicrobial Resistance Coordination and Strategy Unit
Attachment 7_WS-CDC ARX_Creative Concepts_6.3.pdf
06/14/2024
Determination of Non-applicability
Attachment 8_Human Subjects Determination Memo.pdf
06/14/2024
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.